Insurance Executives Refused to Pay for the Cancer Treatment That Could Have Saved Him. This Is How They Did It.

HealthLeaders Media November 15, 2023
ProPublica

A Michigan law requires coverage of cancer drugs. One insurer came up with a ‘defensible’ way to avoid paying for treatments that offered Forrest VanPatten his last chance for survival. ‘We crossed the line,’ says a former executive.

KEY TAKEAWAYS

Across the country, health insurers are flouting state laws like the one in Michigan, created to guarantee access to critical medical care.

Fed up with insurers saying no too often, state legislators thought they’d solved the problem by passing hundreds of laws spelling out exactly what had to be covered.

But companies have continued to dodge bills for pricey treatments, even as industry profits have risen.

ProPublica identified dozens of cases in which plans refused to pay for high-stakes treatments...

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